Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentComplications
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Complications
Systemic lupus erythematosus (SLE), also known as lupus, is anautoimmune diseasein which theimmune systemmistakenly attacks healthy tissues throughout the body. With lupus, a person’s overactive immune system causesinflammationthat damages connective tissues, including cartilage and the lining of blood vessels. SLE is one of several types of lupus and the most common form.
Here is what you need to know about SLE, including prevalence, symptoms, causes and risk factors, diagnosis, treatment, and complications.
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The symptoms of SLE vary from person to person and change over time. The most common symptoms are:
Some of the first symptoms of SLE are extreme fatigue, malaise (a general feeling of illness), fever, weight loss, and appetite loss.Most people with SLE will go on to develop joint pain on both sides of the body and muscle pain and weakness.
Skin problems are also common in SLE, especially a flat rash called a butterfly rash that spreads across the cheeks and on the bridge of the nose. Other skin problems include:
Some people with SLE will develop kidney problems. In fact, up to half of the people with SLE will have renal involvement. Heart problems are also common in SLE, including inflammation of the membrane around the heart (pericarditis) and heart valve problems, which control blood flow to the heart. Heart disease is more common in people with SLE.
The Connection Between Lupus and Heart Disease
Inflammation from SLE can also cause damage to the nervous system and lead toperipheral neuropathy(damage to the peripheral nerves causing weakness, numbness, and pain in the hands, arms, legs, and feet), seizures, stroke, and cognitive impairment. Anxiety and depression are also common in people with SLE.
People who live with SLE have periods of the disease in which their condition worsens—called flare-ups—and other times in which the condition gets better—called remissions. SLE is a progressive condition, which means it will get worse with time and potentially cause damage to major organs of the body. While there is no cure for SLE, this condition is treatable, and medications can slow down and reduce the disease’s effects.
Lupussymptoms are also seen in other diseases, which can make confirming a diagnosis difficult. If you experience any of these symptoms, make an appointment to see your healthcare provider who can run tests to make an accurate diagnosis.
Signs and Symptoms of Lupus
Much like other autoimmune diseases, an exact cause of SLE is not known. However, there are several risk factors associated with the conditions.
Genes
In most people with the disease, there isn’t a single gene mutation that causes lupus. Nevertheless, lupus and other autoimmune diseases tends to run in families.
Studies on twins, siblings, and other first-degree relatives (including parents) and second-degree relatives (including aunts, uncles, and grandparents) all indicate a strong genetic component to SLE. In studies of identical twins, if one twin has lupus, the other twin has lupus roughly half of the time.
Environment
Certainenvironmental triggersare believed to contribute to disease development. These include ultraviolet (UV) rays from the sun, certain medications, viruses, physical and emotional stress, and trauma.
Sex Hormones
SLE affects women far more often than men. Research indicates that sex hormones like estrogen play a part in the development of SLE, although the exact mechanisms remain unclear.
Prevalence
According to theLupus Foundation of America, up to 1.5 million Americans and up to 5 million people worldwide have some form of lupus.
Lupus tends to affect mostly women of childbearing age, but anyone can develop lupus, even children. According to the Centers for Disease Control and Prevention (CDC), women of all ages are far more affected than men—with estimates of four to 12 women for every one man.
Lupus also affects children. Children account for 20% of all cases, according to the American College of Rheumatology.
Some ethnic groups, including African Americans, Hispanics and Latinos, Asians, and American Indians, have a higher risk in comparison to Whites.
The CDC estimates there are 16,000 new diagnoses of lupus each year.
Vasculitis: Treatment for Autoimmune Symptoms
Making a diagnosis of SLE can be difficult because the signs and symptoms of the disease vary from person to person over time and overlap with other disorders. Additionally, there is no one test to confirm a diagnosis of SLE.
However, your healthcare provider can perform a physical exam, ask about medical history, including signs and symptoms, and perform laboratory tests, imaging, and/or perform a biopsy.
Physical Exam and Medical History
Your healthcare provider will look for rashes and other visible signs of SLE. Tell your healthcare provider if lupus or other autoimmune diseases run in your family.
You will be asked about symptoms of SLE you may be experiencing, such as a butterfly rash, mucous membrane ulcers, joint pain, tenderness and swelling, hair loss, and signs of lung or heart involvement, such as irregular heartbeats and heart murmurs.
Laboratory Tests
This testing includes both urine and blood tests.
Acomplete blood count(CBC) looks for abnormalities in white blood cell, red blood cell, and platelet counts (which are often low in lupus).
Anerythrocyte sedimentation rate(ESR) blood test can indicate increased inflammatory activity in the body, but an ESR test is abnormal in a number of conditions, and not just SLE.
Other blood tests assess kidneys and look for antinuclear antibodies which, if present, may indicate that an autoimmune process is at work. Further antibody tests may be performed to look for other antibodies that are more specific to SLE.
A urinalysis looks for increased protein levels or red blood cells in urine, which are notable if SLE has affected the kidneys.
Imaging
If your healthcare provider suspects SLE is affecting your heart or lungs, imaging may reveal shadows that suggest fluid on the lungs or inflammation of the lungs.
Anechocardiogramuses sound waves to produce imaging of the beating heart to check for valve problems and other heart problems.
Biopsy
If lupus affects the kidneys, your healthcare provider will want to know the type, so a sample of tissue will be taken and tested to determine the best treatment course. A skin biopsy can also help confirm a diagnosis of lupus when it affects the skin.
If your healthcare provider suspects or confirms SLE, you will likely be referred to a rheumatologist. This is a healthcare provider who specialists in the treatment of joint diseases and autoimmune diseases.
How Lupus Is Diagnosed
There is no cure for SLE, but the condition is treatable. According theLupus Foundation of America, goals of treatment may include:
Treatment options depend on how severe a person’s symptoms are and what parts of the body SLE is affecting. Treatments may include:
Ask your healthcare provider about what diet and lifestyle changes you can incorporate into your treatment plan. Your healthcare provider may recommend avoiding certain foods and minimizing stress to reduce flare-ups.
If you are using steroid therapy, ask aboutosteoporosisscreenings since these medications can thin out bones. Your healthcare provider may also suggest preventive care, including vaccinations and screenings for the heart and kidneys.
Lupus Treatment Options
SLE is known for causing damage and complications to body systems. Some of these complications are:
Kidney Problems
Kidney problems are common in people with lupus. According to theNational Institute of Diabetes and Digestive and Kidney Diseases, up to half of the adults with lupus will develop a kidney condition calledlupus nephritis, and up to 80% of children will develop lupus nephritis.
Heart Problems
Lupus inflammation can affect the heart in several ways. In addition, people living with lupus have increased long-term risk of developing cardiovascular disease, which is a leading cause of death.
Lung Problems
SLE causes lung inflammation in about 50% of the people with the condition.
Lung problems associated with SLE are:
Blood-Related Problems
Blood problems are common in people with SLE, but they do not always cause obvious symptoms. Some of these problems may be severe or threatening.
These may include:
Nervous System Problems
Nervous system issues related to SLE may include:
Digestive Problems
Digestive system problems associated with SLE may include:
Mental Health Problems
Coping with physical and emotional effects of SLE isn’t easy. The effects can lead to difficulties in managing mental health. Mental health problems associated with SLE include:
According a 2018 report from the Korean College of Rheumatology, depression affects up to 39% of people with lupus, while mania affected around 3%.Further, anxiety disorders are common in lupus (with a prevalence of 40%) and include prominent anxiety, generalized anxiety, panic disorders, and obsessive-compulsive disorders.
Lupus psychosis is less common and most often seen in the early stages of lupus. It may be more common in people who are treating with high doses of corticosteroids.
How Lupus Affects the Aging Process
Controlling SLE with appropriate treatment can reduce and even prevent many of these potentially life-threatening disease complications.
A Word From Verywell
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Genetics Home Reference.Systemic lupus erythematosus.Kuhn A, Bonsmann G, Anders HJ, et al.The diagnosis and treatment of systemic lupus erythematosus.Dtsch Arztebl Int. 2015 Jun 19;112(25):423-32. doi:10.3238/arztebl.2015.0423Knight JS, Kaplan MJ.Cardiovascular disease in lupus: insights and updates.Curr Opin Rheumatol. 2013;25(5):597–605. doi:10.1097/BOR.0b013e328363eba3Grygiel-Górniak B, Puszczewicz MJ.The influence of endogenous and exogenous sex hormones on systemic lupus erythematosus in pre- and postmenopausal women.Prz Menopauzalny. 2014;13(4):262-6. doi:10.5114/pm.2014.45003GK Roper.Lupus awareness survey for the Lupus Foundation Of America [Executive Summary Report]. Lupus Foundation of America.Centers for Disease Control and Prevention.Systemic lupus erythematosus (SLE).American College of Rheumatology.Lupus.Lupus Foundation of America.Finding the treatment approach for you.The National Institute of Diabetes and Digestive and Kidney Diseases.Lupus and kidney disease (lupus nephritis).Johns Hopkins Lupus Center.How lupus affects the lungs.Yoon S, Kang DH, Choi TY.Psychiatric symptoms in systemic lupus erythematosus: diagnosis and treatment.Int J Rheum Dis. 2019;26(2), 93. doi:10.4078/jrd.2019.26.2.93
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Genetics Home Reference.Systemic lupus erythematosus.Kuhn A, Bonsmann G, Anders HJ, et al.The diagnosis and treatment of systemic lupus erythematosus.Dtsch Arztebl Int. 2015 Jun 19;112(25):423-32. doi:10.3238/arztebl.2015.0423Knight JS, Kaplan MJ.Cardiovascular disease in lupus: insights and updates.Curr Opin Rheumatol. 2013;25(5):597–605. doi:10.1097/BOR.0b013e328363eba3Grygiel-Górniak B, Puszczewicz MJ.The influence of endogenous and exogenous sex hormones on systemic lupus erythematosus in pre- and postmenopausal women.Prz Menopauzalny. 2014;13(4):262-6. doi:10.5114/pm.2014.45003GK Roper.Lupus awareness survey for the Lupus Foundation Of America [Executive Summary Report]. Lupus Foundation of America.Centers for Disease Control and Prevention.Systemic lupus erythematosus (SLE).American College of Rheumatology.Lupus.Lupus Foundation of America.Finding the treatment approach for you.The National Institute of Diabetes and Digestive and Kidney Diseases.Lupus and kidney disease (lupus nephritis).Johns Hopkins Lupus Center.How lupus affects the lungs.Yoon S, Kang DH, Choi TY.Psychiatric symptoms in systemic lupus erythematosus: diagnosis and treatment.Int J Rheum Dis. 2019;26(2), 93. doi:10.4078/jrd.2019.26.2.93
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Genetics Home Reference.Systemic lupus erythematosus.Kuhn A, Bonsmann G, Anders HJ, et al.The diagnosis and treatment of systemic lupus erythematosus.Dtsch Arztebl Int. 2015 Jun 19;112(25):423-32. doi:10.3238/arztebl.2015.0423Knight JS, Kaplan MJ.Cardiovascular disease in lupus: insights and updates.Curr Opin Rheumatol. 2013;25(5):597–605. doi:10.1097/BOR.0b013e328363eba3Grygiel-Górniak B, Puszczewicz MJ.The influence of endogenous and exogenous sex hormones on systemic lupus erythematosus in pre- and postmenopausal women.Prz Menopauzalny. 2014;13(4):262-6. doi:10.5114/pm.2014.45003GK Roper.Lupus awareness survey for the Lupus Foundation Of America [Executive Summary Report]. Lupus Foundation of America.Centers for Disease Control and Prevention.Systemic lupus erythematosus (SLE).American College of Rheumatology.Lupus.Lupus Foundation of America.Finding the treatment approach for you.The National Institute of Diabetes and Digestive and Kidney Diseases.Lupus and kidney disease (lupus nephritis).Johns Hopkins Lupus Center.How lupus affects the lungs.Yoon S, Kang DH, Choi TY.Psychiatric symptoms in systemic lupus erythematosus: diagnosis and treatment.Int J Rheum Dis. 2019;26(2), 93. doi:10.4078/jrd.2019.26.2.93
Genetics Home Reference.Systemic lupus erythematosus.
Kuhn A, Bonsmann G, Anders HJ, et al.The diagnosis and treatment of systemic lupus erythematosus.Dtsch Arztebl Int. 2015 Jun 19;112(25):423-32. doi:10.3238/arztebl.2015.0423
Knight JS, Kaplan MJ.Cardiovascular disease in lupus: insights and updates.Curr Opin Rheumatol. 2013;25(5):597–605. doi:10.1097/BOR.0b013e328363eba3
Grygiel-Górniak B, Puszczewicz MJ.The influence of endogenous and exogenous sex hormones on systemic lupus erythematosus in pre- and postmenopausal women.Prz Menopauzalny. 2014;13(4):262-6. doi:10.5114/pm.2014.45003
GK Roper.Lupus awareness survey for the Lupus Foundation Of America [Executive Summary Report]. Lupus Foundation of America.
Centers for Disease Control and Prevention.Systemic lupus erythematosus (SLE).
American College of Rheumatology.Lupus.
Lupus Foundation of America.Finding the treatment approach for you.
The National Institute of Diabetes and Digestive and Kidney Diseases.Lupus and kidney disease (lupus nephritis).
Johns Hopkins Lupus Center.How lupus affects the lungs.
Yoon S, Kang DH, Choi TY.Psychiatric symptoms in systemic lupus erythematosus: diagnosis and treatment.Int J Rheum Dis. 2019;26(2), 93. doi:10.4078/jrd.2019.26.2.93
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